THE BUSINESS OF HANDS

Mr Lorenzo Garagnani considers the market for hand rejuvenation

MR LORENZO GARAGNANI

Mr Lorenzo Garagnani OSI, MD, FRCS, PGDip (Aesthetic and Wellness Medicine), EBHS diploma in Hand Surgery, is an internationally renowned adult and paediatric consultant hand surgeon and aesthetic doctor. He is a founder and was first lead of the orthoplastic hand unit of Guy’s and St Thomas’ NHS Foundation Trust in London. Mr Garagnani is also honorary reader at the Faculty of Life Sciences and Medicine of King’s College London and the medical director of the SE1 Medical Aesthetics clinic in London.

Over the last two years, I have presented in 13 different cities, across nine different countries on hand rejuvenation, in particular, the injection techniques that I developed and teach in my practical masterclasses. The journey has been such a joy and I will be forever grateful for the invites and the people I have met along the way. At every meeting, sometimes more than once, I am told “I’ve attempted hand rejuvenation in my practice before, there is no market for hands, so I abandoned it”. I am also told “I do hand rejuvenation injections too”, often from practitioners that, on further discussion, lack adequate anatomical knowledge or understanding of the indications and risks.

Without being confrontational, I feel these statements need to be addressed.

There may not have been a market 15 years ago; however, the market now is huge. If you are not offering hand rejuvenation to your existing patients, another practitioner is.

It’s a matter of statistics, advancements in techniques and patient education. Over the past 15 years, facial aesthetic patient numbers have increased dramatically, to the point where facial treatments are now considered pretty mainstream. There are often multiple aesthetic clinics on every high street, and a significant percentage of the population is visiting these clinics. Alarge cohort of patients, aged upwards of 40, have been having facial aesthetic treatments for over a decade, and it is these patients that have now forged the emerging hand rejuvenation market.

THE TIME IS NOW

The patient numbers are there and the indication is there, as there is a discrepancy between the aesthetic appearance of the face versus the hands of patients who are now older than when they first embarked on their facial aesthetics journey. Safer techniques have also been developed, products have continuously improved and the industry marketing machines are oiling up their strategies to sell their hand rejuvenation products.

With statistics covered and attention grabbed, let’s address the advancements in techniques, increased safety and patient education.

If you are considering adding body injectables to your portfolio of treatments, and, in light of awful horror stories about aesthetic treatments on other parts of the body, one of which recently ended tragically, I beg of us all to respect the following: appropriate training and qualifications; ethics; knowledge of anatomy; use of anatomically based techniques; appropriate patient consultation and indications; prioritisation of patient safety; appropriate antisepsis; and real expertise.The days of ‘dabbling’ and masquerading as something you are not are numbered. Transparency is paramount if we are going to improve safety.

Treated (left) and untreated (right)

It is crucial to complete appropriate training. Research the different techniques, and consult hand experts, i.e. practitioners who have actual expertise in the hand and an established practice in hand treatments.

Now you have researched and trained, it’s time to educate your patients. For my anatomically-based hand rejuvenation injection techniques with dermal fillers, you are looking for patients who would benefit from contouring and improvements in tissue tone and texture. For younger patients, skin booster treatment alone may be sufficient.

The best way to discuss indications and outcomes with your patients is to have information and case study pictures in your clinic, as well as on your website or social media (after obtaining appropriate patient consent, obviously). Also, you will need to clearly explain any risks and potential complications.

As the percentage of patients choosing facial treatments increases, so does your opportunity to have a healthy practice focussing on hands.